Is Embryo Storage FSA Eligible for Reimbursement?
Navigate the complexities of FSA eligibility for embryo storage. Understand IRS guidelines, documentation, and the reimbursement process for this specialized medical expense.
Flexible Spending Accounts (FSAs) offer a way for individuals to pay for qualified medical expenses using pre-tax dollars. These accounts can help reduce overall healthcare costs by allowing participants to set aside a portion of their income before taxes are calculated. This article examines the eligibility of various medical services for FSA reimbursement, focusing on specific treatments and procedures.
Understanding FSA Eligibility
Flexible Spending Accounts are governed by rules established by the Internal Revenue Service (IRS), which define what constitutes a qualified medical expense. According to IRS Publication 502, “Medical and Dental Expenses,” medical care encompasses costs for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any part or function of the body. Expenses must primarily serve to alleviate or prevent a physical or mental defect or illness. Costs for general health benefits, such as vitamins not prescribed for a specific condition, are not eligible.
Embryo Storage and Medical Expense Criteria
Embryo storage can be considered an FSA-eligible medical expense, particularly when it is part of a medically necessary reproduction plan. This applies to storage that is temporary and intended for immediate use, within a 12-month period. The IRS views fertility treatments, including in vitro fertilization (IVF) and temporary storage of eggs or sperm, as eligible medical expenses. However, long-term embryo storage, exceeding one year or for potential future use without an immediate medical need, is not covered.
For embryo storage to be eligible, a Letter of Medical Necessity (LMN) is often required. This document, provided by a medical professional, must explain why the storage is medically necessary for treating a specific health condition. The LMN outlines the diagnosis, the recommended treatment plan involving embryo storage, and the expected duration of the storage, aligning it with temporary use criteria. This ensures the expense is tied to a medical purpose rather than general elective use.
Required Documentation for Reimbursement
To substantiate an FSA claim for embryo storage, documentation is necessary. An itemized receipt from the storage facility or an Explanation of Benefits (EOB) from an insurance provider is required. These documents must clearly present information: the date(s) of service, the patient’s name, the provider’s name, a detailed description of the service (e.g., “embryo storage”), and the total cost incurred.
Credit card receipts or canceled checks alone are insufficient as they lack itemized detail. If a Letter of Medical Necessity (LMN) was required for eligibility, a copy of this letter must also be submitted with the claim. Maintaining copies of all submitted documentation for personal records is recommended, as the IRS may request verification.
Submitting Your FSA Claim
Once necessary documentation is gathered, submitting an FSA claim for reimbursement is straightforward. Most FSA administrators offer multiple submission methods, including online portals, mobile applications, or traditional mail and fax. When submitting online or via an app, users fill out a digital claim form and upload images of their itemized receipts and, if required, the Letter of Medical Necessity.
After submission, the FSA administrator reviews the claim to verify eligibility against IRS guidelines and plan rules. Processing times can vary, from a few days to weeks. If approved, reimbursement is issued via direct deposit to a linked bank account or by check. Sometimes, additional documentation may be requested to clarify expense details.